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Book Cover

Title Value-based approaches to spine care : sustainable practices in an era of over-utilization / Rajiv K. Sethi, Anna K. Wright, Michael G. Vitale, editors
Published Cham : Springer, 2020
Online access available from:
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Description 1 online resource (206 pages)
Contents Intro -- Preface -- Contents -- Contributors -- 1: Macro Trends in Healthcare Delivery -- The Spiraling Cost of Healthcare -- Models of Value-Based Reimbursement -- Accountable Care Organization (ACO) -- Bundled Payment of Care Improvement (BPCI) -- Patient-Centered Medical Home (PCMH) -- Summary of VBR Models -- Other Macroeconomic Trends -- Price Controls and Decreases in Reimbursement -- Consolidation -- New Technology -- Telehealth -- Smart Pharmaceuticals and Devices -- Genetics -- Wearable Devices -- Big Data and Artificial Intelligence -- Conclusion: Finding Signal in the Noise
3: The Bree Collaborative Bundle for Lumbar Fusion: Evolution of a Community Standard for Quality -- Identifying and Managing Uncomplicated Back Pain: The Spine Clinic -- Engagement with Employers and the Marketplace Collaborative Model -- Redesigning the Care Pathway for Uncomplicated Back Pain -- Improved Quality and Timeliness of Care for Uncomplicated Back Pain -- Financial Consequences for Providers -- Lessons Learned from Starbucks, the Marketplace Collaborative, and Spine Clinic -- Replicating the Spine Clinic Model -- Lessons Learned from Intel's Collaborative and the Spine Clinic
Beyond Spine Clinic: Contributions from Spine Surgery and Orthopedics -- The Robert Bree Collaborative: Putting It All Together -- Bree Collaborative Work Group on Lumbar Fusion -- The Evidence Table -- Cycle One: Standards for Appropriateness for Lumbar Fusion -- Cycle Two: Fitness for Surgery -- Cycle Three: Best Practice Surgery -- Cycle Four: Rapid Return to Function -- The Multidisciplinary Conference -- The Personal Care Partner -- Quality Measures -- The Warranty Against Avoidable Remissions -- Response of Health-Care Stakeholders to Surgical Bundles -- Employers -- Health Plans
Providers -- Summary -- References -- 4: Multidisciplinary Evaluation Improves the Value of Lumbar Spine Care -- Multidisciplinary Conferences -- Multidisciplinary Clinics -- Discussion -- Conclusions -- References -- 5: Using Lean Process Improvement to Enhance Safety and Value -- What Is Standard Work? -- The Toyota Production System and Its Application in Healthcare -- What Is the Virginia Mason Production System? How Does This System Root Out Variability? -- Cultural Aspects of Hierarchy in Medicine and Surgery (the Old Standard Way)
Summary Beginning with a review of current trends in health care delivery leading to more value-based platforms, this unique and up-to-date book then focuses on how modern spine care is being shaped by the aging population, scientific and technological advancements, and the economic impact of various treatment modalities, providing insight into the seminal efforts surrounding sustainable spine care guideline development. The over-utilization of spine fusion surgery and adult spinal deformity are presented as examples that have led to a decline in the value of care delivered, as well as how a multidisciplinary evaluation by the range of clinicians involved in spine surgery can revise recommendations for management. The benefits and risks of LEAN methodology for streamlining and standardizing spine care approaches are discussed, and the specific approach of the Seattle Spine Team is presented as an example of successful system-wide improvement. Similar changes to outcome measurement, specifically for adult spinal deformity, are described. Last, the future of technology in spine care is presented, including robotics, nanotechnology, 3D printing, and the use of biologics and biomaterials. Given the broad scope of topics covered in this book, the intended audience includes not only orthopedic and spinal surgeons, neurosurgeons, physiatrists, and medical students, residents and fellows, but also hospital CEOs, CMOs, administrators, health services researchers, and health care policymakers, consultants and strategists
Notes Adult Spinal Deformity Surgery as a Case Study (the Need for Change)
Includes index
Bibliography References-2: Evaluating Policy Effects in the Treatment of Lumbar Fusion-Background-Rates and Trends of Lumbar Fusion-Washington State Worker Compensation System-Blue Cross Blue Shield of North Carolina Policy-Early Effects of Medicare's Bundled Payment Program for Lumbar Fusion-Epidemiology of Bone Morphogenetic Protein in Lumbar Fusion-Where Are Spine Policies Going: Emphasizing Outcomes-Measuring Quality in Back Pain: Medicare's Hospital Compare and the OP-8 Measure-Washington State Provider Profiling-Conclusions-References
Notes Print version record
Subject Spine -- Surgery.
Spine -- Wounds and injuries -- Surgery
Spinal Diseases -- therapy.
Spine -- Surgery.
Form Electronic book
Author Sethi, Rajiv K.
Vitale, Michael (Professor of pediatric orthopaedic surgery and neurosurgery)
Wright, Anna K
ISBN 3030319458